Active NPI
Maceo P Paige
- Non-emergency Medical Transport (VAN)
- Latta, SC
National Provider Identifier
1972209120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Non-emergency Medical Transport (VAN)
- Practice address
- 519 Danwoody Rd
Latta, SC 29565-5349 - Phone
- (843) 624-5091
- NPI assigned
- Jan 31, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Non-emergency Medical Transport (VAN) | 343900000X | Primary |
Addresses
Primary practice location
519 Danwoody Rd
Latta, SC 29565-5349
Mailing address
519 Danwoody Rd
Latta, SC 29565-5349
Phone (843) 624-5091
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 831257126 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675123200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675123200000",
"number": "1972209120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "519 DANWOODY RD",
"city": "LATTA",
"state": "SC",
"postal_code": "295655349",
"telephone_number": "843-624-5091"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "519 DANWOODY RD",
"city": "LATTA",
"state": "SC",
"postal_code": "295655349",
"telephone_number": "843-624-5091"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAIGE",
"first_name": "MACEO",
"middle_name": "P",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-01-31",
"last_updated": "2023-01-31",
"certification_date": "2023-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "343900000X",
"taxonomy_group": "",
"desc": "Non-emergency Medical Transport (VAN)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "831257126",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Latta, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.